We are likely putting undue stress on our spine and setting ourselves up for serious injury without even knowing it. New York Spine Surgery and Rehabilitation Medicine’s Dr. Ken Hansraj joins Lunch Break with Tanya Rivero and explains activities that are the biggest culprits, including breast augmentation and playing Pokemon Go. Photo: AP

In this book, the factors that govern blood loss and blood transfusion are discussed.

This manuscript presents the comprehensive preparation of a patient for bloodless spine surgery, techniques for diminishing blood loss in the operating room, postoperative considerations, and includes case reports of patients who have undergone surgery using the blood management methods outlined.

Digital images and illustrations are incorporated throughout the book to show important concepts, and a dictionary is provided to thoroughly explain the important factors in bloodless surgery.

An effort was made to ensure that the information is provided for readers who come from a non-medical background, with adhering to the basics.

Jehovah’s Witness: It is estimated that there are more than 2 million Jehovah’s Witnesses in the United States. Followers of this religion believe that the Bible prohibits blood or blood product transfusion (Acts 15:28-29). Typically, patients of this religion do not accept transfusions of whole blood, packed cells, white blood cells, platelets, or plasma or autotransfusion of predeposited blood. Some witnesses may permit infusion of albumin, clotting factor solutions, or dextran or other plasma expanders and intraoperative autotransfusion, done under closed loop technique.

Even though a transfusion may be necessary to save a patient’s life, the administration of blood and/or blood products in the face of refusal after informed consent can be legally considered a violation of a patient’s right to control what is done to his or her body. In the awake and otherwise competent adult, courts have ruled that physicians cannot be held liable if they comply with a patient’s directive and withhold life-saving blood administration following specific and detailed informed consent of the consequences of such an omission of treatment. The issue becomes diificult when patients are unconscious (most Jehovah’s witnesses carry cards informing medical personnel of their religious beliefs), or minors

A machine, commonly known as a cell saver, is used to recover red blood cells lost during spinal surgery, and return them to circulation in the patient’s body. This cell saver machine was developed during the Vietnam war and used extensively in the field

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Jehovah’s Witness: It is estimated that there are more than 2 million Jehovah’s Witnesses in the United States. Followers of this religion believe that the Bible prohibits blood or blood product transfusion (Acts 15:28-29). Typically, patients of this religion do not accept transfusions of whole blood, packed cells, white blood cells, platelets, or plasma or autotransfusion of predeposited blood. Some witnesses may permit infusion of albumin, clotting factor solutions, or dextran or other plasma expanders and intraoperative autotransfusion, done under closed loop technique.

After you pop the question, the wedding planning begins. While your fiance is off figuring out flowers, table settings and dresses, it’s the perfect time for you to make a plan of your own – a fitness plan. The months between your proposal and when she’s coming down the aisle are just enough time to not only get yourself in shape to look (almost) as good as she does in the thousands of wedding pictures, but to make sure your marriage is much less “in sickness” and much more “in health.”

Cut the carbs and up the protein. If you’re trying to look better in your suit or tux, it doesn’t start in the gym, says personal trainer John Rowley, founder of the 52 Million Pound Challenge that aims to get Americans to lose 52 million pounds this year. “The most important thing is nutrition. You need to watch what goes into your mouth.”

Rowley, who recently helped his son get in shape for his wedding, is an advocate of cutting carbs out of your diet completely. Carbohydrates are your body’s main source of fuel, he says, and eating too many is like filling your gas tank to the point that it overflows – spilling out as fat throughout your body.

While giving up carbs is no doubt difficult, you can eat all the protein you want – “preferably from lean sources,” Rowley says. “A good thing to keep in mind is that the fewer the legs the animal has, the better it is for you. Fish is better than chicken, which is better than beef. If you love red meat, try bison meat instead of beef.”

In addition to upping your protein intake, make sure your fat intake is from “good fats” such as coconut oil and olive oil, Rowley says, and be sure to drink plenty of water – not soda or other sugary drinks.

Avoid cold feet with a post-workout cold shower. Once you settle into a habit of healthy eating, you should start to see the pounds drop off, and that’s when it will help to hit the gym, says Rowley – who should know. At the Brooklyn gym he ran, he hosted such famed weightlifters as Arnold Schwarzenegger and Lou Ferrigno. “Make sure you focus on resistance exercises and weightlifting,” he says. “You don’t have to look like Arnold, but the more muscle you have, the faster your metabolism.”

Going to the gym three days per week is enough to see results, Rowley says. As for routine, he advocates working out your chest, shoulders and triceps on Monday, legs on Wednesday, and your back on Friday. The whole workout should take about 20 minutes, he says, and you can tack on 15 minutes of cardio afterward. Just make sure not to rest more than 20 to 30 seconds between sets.

Let’s face it – no one wants to see their beer belly sticking out of their tuxedo in their wedding pictures. But Rowley says one of the biggest mistakes grooms make is trying to target their belly fat by doing sit-ups and crunches. “There’s no way to target fat to lose,” he says. “Some people might lose it from their belly first, but others lose it from their hips or their face first. It’s based on your body. Do it long enough, and you’ll see the results where you want them.”

Be flexible – in marriage and with your spine. But just being in shape isn’t enough to look good for your wedding day. You need to improve your posture as well, says Kenneth Hansraj, an orthopedic surgeon at Mid Hudson Regional Hospital of Westchester Medical Center in New York. “No one wants to see a hunched-over groom standing at the altar,” he says. “Posture is king.”

So what is good posture? It’s positioning your ears above your shoulders and your shoulder blades back. Practice this position frequently, and it will become a habit. And once it does, you’ll notice that you’ll not only look better, but feel better, too. “Studies show that when you take people and correct their posture,” Hansraj says, “their testosterone levels increase and their levels of the stress hormone cortisol goes down.”

In addition to practicing the position, do some stretching exercises to help improve your posture. “Posture is all about flexibility,” Hansraj says. “Bend your head and neck forward and backward and side to side, feeling your spine stretch as you do. Then, do the same with your back while standing up.”

Say “I do” to working out together. While following this advice will help you look your best on your wedding day, doing it alone is a missed opportunity to bond with your spouse, Rowley says. “It’s an opportunity for the couple to get in shape together,” he says. “Going after a similar goal together strengthens relationships and can really prepare you to face the challenges of marriage.”

Put everything together and you have a recipe for much more than a happy wedding day. If you make fitness a habit, Rowley points out, “it’s going to continue throughout your marriage and help you live a long, healthy life for your wife and kids.”

Dr. Hansraj says “Improve your Posture”

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]]>https://realspinesurgery.com/grooms-guide-posture-fitness-will/feed/0“Ohhh!! That Nagging Pain In The Neck: Understanding Slipped Discs”https://realspinesurgery.com/ohhh-nagging-pain-neck-understanding-slipped-discs/
https://realspinesurgery.com/ohhh-nagging-pain-neck-understanding-slipped-discs/#commentsFri, 05 Aug 2016 18:10:09 +0000https://realspinesurgery.com/?p=3964[vc_row][vc_column][vc_column_text]THE NORMAL DISC is a combination of strong connective tissue that connects one vertebra to the next. This human shock absorber consists of a tough outer layer called the annulus fibrosis. A herniated disc exists when the gel-like center called the nucleus pulposus exits through a hole caused by damage to the annulus fibrosis.

Classically, the patient complains of neck pain and a sharp, lancing pain progressing distally from the neck, shoulder blade and shoulder into the arm in a specific zone. Radiculopathy refers to the irritation of a nerve root, causing symptoms (pain, numbness, weakness, plus/minus reflex changes) in the zone of the nerve root.

Numbness, tingling or weakness of the leg is called sciatica. Similar symptoms may be experienced in the arms or around the trunk.

Traditional treatments include early motion, traction, physical therapy, massage, modalities, acupuncture, osteopathic manipulation, chiropractic care, pain management, activity avoidance, and activity with job modifications. Heat in the form of long, hot showers, sauna, and heat packs can help reduce pain. Application of cold packs and gels could also offer some relief. Medications in the classes of aspirin, non steroidal anti-inflammatories, muscle relaxants, oral steroids, antidepressants, and narcotics could also be recommended. External stabilization in the form of a brace might prove to be beneficial in the short term.

When the patient is less symptomatic, specific treatments such as cervical stabilization will often assist with the resumption of function and endurance. Yoga and Pilates may be used to strengthen core muscles, while Medx treatment might help to strengthen neck muscles.

Cervical injections such as epidural steroid, facet blocks, or radiofrequency ablation may be recommended.

Upper back pain and neck pain are a common part of the natural aging process, since joints and bones of the neck change as you grow older, much like your creaky knees and an achy hip.

A stiff neck or long-term chronic pain in the area typically means you’ve inflamed one or more of the 14 joints in your cervical spine, which surround one (or more) of seven vertebrae in your neck.

There are 48 joints within the human spine, and each one is a jewel.

Many biomechanical factors can affect your neck as part of the normal aging process. For example, the spinal canal may narrow with age and overuse, pressing on the cervical spinal cord and nerves of the neck, causing pain and symptoms in the arms and hands.

Injuries from car accidents and falls, and poor posture or sleeping patterns, can also contribute to osteoarthritis and neck pain. Your resulting pain may range from mild discomfort to severe throbbing that can last for days or weeks

Adjust Your Posture

Quite literally, proper posture starts with the brain and mindfulness, and anatomically, at the base of your skull. Most people don’t realize that spine health and superior posture start at the jawline and nape of the neck, thread through the cervical spine (plus neck vertebrae), and end up weaving south toward the lumbar spine and through the end of the spinal column or tailbone, commonly called your coccyx.

Maintaining proper posture throughout your day can help you tire less easily and sidestep neck injury. Many simple exercises designed to improve posture are also a great way to help increase your back and core strength. It all starts with awareness of your body in space – how you sit during a long commute, how you stand in line at the bank, even your walking gait.

Poor posture and ensuing neck or upper back pain, in fact, may reflect more on your overall health than you might think. Recent research finds a connection between poor or unhealthy posture and a variety of serious health conditions, including depression, breathing problems, hormone imbalances and sleep disorders.

Much research shows that a painful range of motion in your neck or chronic pain in the upper back and neck may be soothed by one of more of these fixes:

A hot pack on the area several times per day to soothe chronic aches;

Aspirin, Advil, Aleve (anti-inflammatory pain medications);

Turmeric, ginger, and other spices or supplements known to battle inflammation;

Occupational therapy or a series of gentle stretches designed to increase your range of motion;

Daily supplements of B6 and B12 vitamins that can increase the health of the nerves along the spine; and

A regimen of gentle stretches that target the area and stabilize the spine or – even better – performing stretches in a long, hot shower to loosen your neck muscles.

Could this Be Neck Arthritis?

Oh, yes, that chronic neck pain could be neck arthritis, and it’s extremely common with age. Women are almost twice as likely as men to develop degenerative arthritis (osteoarthritis) in the neck. However, risk factors are the same for both sexes and include age, past trauma, genetics, sedentary lifestyle, and even excessive body weight – the lower spine endures the brunt of excess weight, but modified gait and posture in obesity can affect the neck spine, too.

Symptoms of neck arthritis may include chronic neck pain, muscle weakness, numbness, stiffness, especially in the morning or after a long rest, headaches and even balance problems. Your first big tip-off will be painful neck and upper back muscles lasting for weeks or months at a time.

Stress and anxiety can result in shallow breathing, which in turn leads to back pain. Here’s why: When you’re anxious, you tend to take short breaths or hold your breath, so the nerves passing through your spine’s 26 joints “freeze up” and cause pain. Taking deep, full breaths opens the lungs, bringing in oxygen and allowing the joints and nerves to move more freely, explains Kenneth Hansraj, MD, author of Key to an Amazing Life: Secrets of the Cervical Spine (Amazon Digital Services, 2012).

OUTSMART PAIN

Make sure you are breathing fully and deeply, and practice alternate nasal breathing daily. Sit tall in a comfortable position and breathe in fully (your torso should expand on the inhale), then pinch your nostrils together, holding in the breath. Release your right nostril and exhale. Then inhale deeply through your right nostril; pinch it closed. Hold, then release your left nostril and exhale. Repeat, working up to at least 5 minutes a day.

Make sure you are breathing fully and deeply, and practice alternate nasal breathing daily. Sit tall in a comfortable position and breathe in fully (your torso should expand on the inhale), then pinch your nostrils together, holding in the breath. Release your right nostril and exhale. Then inhale deeply through your right nostril; pinch it closed. Hold, then release your left nostril and exhale. Repeat, working up to at least 5 minutes a day.

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]]>https://realspinesurgery.com/worry-less-save-back-weightwatchers-magazine-marchapril-2014/feed/0SLEEP WITHOUT STIFFNESS (NewYou)https://realspinesurgery.com/sleep-without-stiffness-newyou/
https://realspinesurgery.com/sleep-without-stiffness-newyou/#respondFri, 05 Aug 2016 18:06:01 +0000https://realspinesurgery.com/?p=3956[vc_row][vc_column][vc_column_text]New You Health Tip:Do’s and dont’s to help prevent neck stiffness and back pain while sleeping.

One of the top reasons Americans visit their doctors each year is spinal problems related to back and neck pain. Dr. Kenneth Hansraj, New York Orthopedic Surgeon and author of Keys to an Amazing Life:Secrets of the Cervical Spine, shares with New You readers the best ways to avoid a stiff neck and sore back while sleeping.

Yoga and disc degenerative disease in cervical and lumbar spine: an MR imaging-based case control study.

The objective of the current study was to find out whether yoga practice was beneficial to the spine by comparing degenerative disc disease in the spines of long-time yoga practitioners and non-yoga practicing controls, using an objective measurement tool, magnetic resonance imaging.

This matched case-control study comprised 18 yoga instructors with teaching experience of more than 10 years and 18 non-yoga practicing asymptomatic individuals randomly selected from a health checkup database. A validated grading scale was used to grade the condition of cervical and lumbar discs seen in magnetic resonance imaging of the spine, and the resulting data analyzed statistically. The mean number of years of yoga practice for the yoga group was 12.9 ± 7.5. The overall (cervical + lumbar) disc scores of the yoga group were significantly lower (indicating less degenerative disc disease) than those of the control group (P < 0.001). The scores for the cervical vertebral discs of the yoga group were also significantly lower than those of the control group (P < 0.001), while the lower scores for the yoga group in the lumbar group approached, but did not reach, statistical significance (P = 0.055).

The scores for individual discs of yoga practitioners showed significantly less degenerative disease at three disc levels, C3/C4, L2/L3 and L3/L4 (P < 0.05). Magnetic resonance imaging showed that the group of long-term practitioners of yoga studied had significantly less degenerative disc disease than a matched control group.[/vc_column_text][/vc_column][/vc_row]

When considering how to maintain a healthy lifestyle, your spine is likely not your primary focus. But according to Dr. Kenneth Hansraj (“Dr. Ken”), renowned orthopedic and spinal surgeon and author of Keys to an Amazing Life: Secrets of the Cervical Spine, it should be. In fact, he points out, approximately 80 percent of us have or will have a spinal problem in our lifetimes.

“While we exercise our abs and legs, we need to also be aware of our spinal health and take strengthening our spines just as seriously,” he explains. “Stress, lack of sunshine and vitamin D all play a role.”

Here, Dr. Ken shares his top tips and techniques for building a healthier and stronger spine with improved posture – which will help avoid unnecessary and painful surgeries:

Deep Belly Breathing: Place your hands on your belly and feel it move as you inhale and exhale. This enables your nerves to move well in the spinal channels, takes stress off the spine and, according to studies, diminishes levels of stress hormone, cortisol, by up to 30 percent. Perform this technique throughout the day, if possible.

Workplace Design and Ergonomics: The workplace can take a heavy toll on your spine. Pay attention to your back’s position in your chair. If you are hunching, leaning frequently or find yourself squinting at the monitor, you will need to make adjustments so that your body is not compensating.

Sunlight and Daylight: Be sure to get enough exposure to sunlight to keep your body’s master clock functioning optimally. People with sufficient exposure to daylight are awakened by a combination of hormones causing them to stand up straighter and focus more on their spine and posture.

Nap and Meditation: Between 2 to 4 p.m., your brain needs a nap. Napping is beneficial in restoring alertness, boosting mood, improving productivity and prolonging life. With deep rest, you are better able to achieve good posture of the spine and are inclined to have better focus, enhancing overall performance.

Exercise Is Medicine: Getting at least 2-3 hours of exercise per week is ideal. Walking is fantastic, since it works the spinal nerves and the spinal facet joints, which are just as important as hip and knee joints and need to be moved just as often for optimal spinal health.

Wholesome Diet: Be thoughtful about what you eat. Dr. Ken says a high-protein diet (organic meats) and fresh vegetables are best, along with a daily multivitamin, vitamin B complex, Omega-3, glucosamine and chondroitin sulfate to improve the metabolism of hip, knee and facet joints. He also suggests avoiding “emotional” eating and planning meals in advance to outsmart temptation to binge.[/vc_column_text][/vc_column][/vc_row]